Am I limited to the amount of times I can see a doctor with Medicare?

Am I limited to the amount of times I can see a doctor with Medicare?

Generally, there is no upper dollar limit on the medical benefits a beneficiary can have once they have Medicare eligibility. As long as a beneficiary is using the medical services that are covered, provided that they are deemed medically necessary, they can continue to use the services as many times as possible.

This is regardless of how much the services cost, in a given year or entire life time. However, there are individual benefits that come with limits. They include the following:

Hospital life time reserve days

Part A covers stays in a hospital for any given illness spell or injury in a time limit of 90 days. It’s referred to as benefit period. There are no limits on the number of the benefit periods a person can have.

However, if your stays in the hospital exceeds 90 days while still under the same injury or illness spell, you are given the option of using part of your 60 life time reserve days. You will be allowed to extend your stay for at higher copayment ($644 per day in 2016). Once your 60 days are gone, you’ll start paying the hospital charges yourself, except for those services that are covered by Part B.

Psychiatric hospital stay

Medicare will cover only inpatient care for 190 days in your life during a psychiatric hospital stay. The 60 reserve days cannot be used to extend the 190 days as explained before, but it can be used to receive inpatient psychiatric treatment from a general hospital.

Skilled nursing facilities

This type of benefit is available for those who have been in the hospital for three days at least and still need skilled nursing. This however comes with limits as well. Medicare will only pay for the full costs for a period of 20 days. Starting from the 21st day to the 100th, you will pay a share. Beyond the 100th day, you will be responsible for the full cost.

If you have any other queries concerning your limits on Medicare health insurance Florida coverage, you can talk to a professional insurance representative at Medicare Medics.

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